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@rh_supplies@rhsupplies
LMIS from the HMIS perspective
Experiences from HISP
9 October 2015
Johan Ivar Sæbø (University of Oslo)
2
Overview
Health Information Systems Programme (HISP) background
Lessons from 20 years of HMIS development
Our experiences with LMIS
Lessons from HMIS applied to LMIS
Some conclusions
3
HISP and DHIS
HISP coordinates development of open source DHIS2 software
47 countries
23 NGOs
8 global health agencies
40.000+ monthly users
DHIS2 originally developed to support HMIS/M&E. M&E the
dominant use still
4
Role of HMIS
From “Helping Health Workers Learn” by David Werner
health commodities
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DHIS2
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Lessons from 20 years of HMIS development
The installed base is important: never a green-field. Cultivation of
what exists must be blended with what is new
Architecting: Which parts will do what. Integration and
interoperability often need organizational change
Bottom-up vs. Top-down: information needs differ. Systems should
be flexible to serve varying needs
Role of technology: Information systems are socio-technical. Non-
technical problems can not be solved by technology
Sustainability: capacity building by far the largest cost.
Evolution: adaptation and change is key. Technology should be
flexible
7
Logistics management on DHIS
How we have gotten into LMIS
Can we use DHIS2 for logistics management?
We need to track where the commodities are
We need to have an ordering system
8
What are we talking about?
Logistics Management Information System, Supply Chain
Information System, Pharmacy Information System, Warehouse
Information System…
A logistics management information system (LMIS) is a system of records
and reports – whether paper-based or electronic – used to aggregate,
analyze, validate and display data (from all levels of the logistics system)
that can be used to make logistics decisions and manage the supply chain.
- Roll Back Malaria Partnership
Quite open-ended. What are we REALLY asked to do?
9
Different needs at different levels: - a simplified view
National level: Forecasting, procurement, customs, quality assurance,
warehouse, finances, fleet management, pick-lists, distribution planning,…
District level: Do the facilities have what they need? Where is it? Are
there stock-outs?
Facility level: Do I have what I need soon? Forecasting, ordering,
inventory balance
Regional level: warehouse, distribution planning, pick lists
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Different needs at different levels: - a simplified view
Warehousing.
National and
regional
Facility
Inventory
Complexity
Users
What are we asked to
make?
Not clear. One system?
Two (?) interoperable
systems?
11
Challenges of combining all in one
Costly
Complex
Limited
Many users
Warehousing. National and regional
Inventory
12
Typical configurations
Commercial ERP
Inventory
and
ordering
13
Challenges with such configurations
- ERPs are costly, typical with fees per-user. Can't cover all users
- There are "free" options for facility inventories and ordering
systems. But none with well established interoperability with
ERPs
- What do these two systems need to share? Consumption,
forecasting. Financial data?
- What role do other systems play? HMIS, HRIS, Lab systems etc
14
Linking to other systems?
Commercial ERP
Inventory
and
ordering
HMIS HRIS
What data to share?
15
Our lessons from HMIS applied to LMIS
The installed base: there are existing routines, technologies etc thatmust be taken into consideration
Architecting: A mix of "heavyweight" ERPs and "lightweight" inventory/ordering system seems to be common
Bottom-up vs. Top-down: Both strategies applicable, for each of thesub-systems
Role of technology: Integration of LMIS, HMIS, HRIS etc "easy". Butwhat data needs to be shared? To whom? Why?
Sustainability: Costly ERPs a challenge. Lightweight open source LMIS at lower levels a good solution
Evolution: As system matures, likely to see increased demand for functionalities also at lower levels, and for integration with othersystems
16
Conclusions
Supply chain information pyramid is "top heavy": more features
needed at national level and warehouses
LMIS: an ecology of different subsystems. Different technological
solutions available, with pros and cons for the different uses/users
Technology will not solve problems. Routines, organizational
structures, local capacity equally important
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